老年慢性阻塞性肺疾病患者的常见老年病和残疾。
Common geriatric conditions and disabilities in older persons with chronic obstructive pulmonary disease.
机构信息
Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
出版信息
Curr Opin Pulm Med. 2011 Dec;17 Suppl 1:S29-34. doi: 10.1097/01.mcp.0000410745.75216.99.
PURPOSE OF REVIEW
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases among older persons worldwide and the rapid increase in commonly associated COPD-disabilities requires urgent awareness among healthcare professionals. The presence of pulmonary and extrapulmonary comorbidities is highly prevalent among COPD patients and complicates treatment management, especially in advanced age. Some of the most common geriatric conditions in COPD patients lead to respiratory function decline, physical function impairment with limited physical performance, cognitive decline, and depression. Unfortunately, the activation of each component may lead to the progression of the other, which, if not corrected, will lead to critical clinical outcomes such as disability (as seen by the worsening of each condition) and death.
RECENT FINDINGS
Studies in older persons with COPD have shown that disability is mainly due to the severity of comorbidities that have been shown to significantly impact treatment options and the prognosis for such individuals. In addition to spirometric functional parameters, exercise performance and efficacy of specific therapeutic interventions may be useful indicators for overall health status and outcomes. The scientific literature underlines the necessity to use additional parameters other than spirometry for COPD patient monitoring.
SUMMARY
As disability is a growing phenomenon in COPD and substantially impacts patient perception of the disease, we will highlight the recent literature regarding the importance of common geriatric conditions leading to disability in older COPD patients. In particular, we will discuss the impact of the following conditions in older patients with COPD: respiratory function decline, physical function impairment, and mood disorders. Clinical use for measuring such parameters in COPD elderly will aid in identifying those at risk for severe clinical decline.
目的综述
慢性阻塞性肺疾病（COPD）是全球老年人中最常见的慢性疾病之一，与 COPD 相关的残疾的迅速增加需要医疗保健专业人员的紧急关注。肺和肺外合并症在 COPD 患者中非常普遍，并使治疗管理复杂化，尤其是在老年患者中。COPD 患者中一些最常见的老年病会导致呼吸功能下降、身体功能受损导致身体活动能力有限、认知能力下降和抑郁。不幸的是，每个组成部分的激活都可能导致其他组成部分的进展，如果不加以纠正，将导致严重的临床后果，如残疾（每种疾病的恶化都可见）和死亡。
最新发现
对 COPD 老年患者的研究表明，残疾主要是由于合并症的严重程度导致的，这些合并症已被证明对治疗选择和这些患者的预后有重大影响。除了肺活量计的功能参数外，运动表现和特定治疗干预的疗效也可能是整体健康状况和结局的有用指标。科学文献强调了除了肺活量计之外，还需要使用其他参数来监测 COPD 患者。
总结
残疾是 COPD 中日益严重的现象，极大地影响了患者对疾病的感知，我们将重点介绍最近关于导致老年 COPD 患者残疾的常见老年病的文献。特别是，我们将讨论以下条件对老年 COPD 患者的影响：呼吸功能下降、身体功能受损和情绪障碍。在 COPD 老年患者中测量这些参数的临床应用将有助于识别那些有严重临床下降风险的患者。
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